Sick building syndrome and perceived indoor environment in relation to energy saving by reduced ventilation flow during heating season: a 1 year intervention study in dwellings

Prenatal risk factors of indoor environment and incidence of childhood eczema in the Japan Environment and Children's Study

The quality of indoor environment is a risk factor for early childhood eczema and atopic dermatitis; however, its influence during pregnancy on childhood eczema in Japan has not been investigated. In this study, we aimed to determine the indoor environmental factors that are associated with eczema in children up to 3 years of age, using national birth cohort data from the Japan Environment and Children's Study (JECS). Information on indoor environments and eczema symptoms until 3 years of age was collected using self-administered questionnaires to the mothers. A total of 71,883 and 58,639 mother-child pairs at 1.5- and 3-years-old, respectively, were included in the former analyses. To account for prenatal indoor risk factors, 17,568 (1.5-years-old) and 7063 (3-years-old) children without indoor mold and/or ETS exposure were included in the final analysis. A higher mold index, gas heater use, parquet flooring use, and frequent insecticide use showed significantly increased risks for childhood eczema up to 3 years of age. These associations were consistent after stratification analysis among children whose parents did not have a history of allergies. The updated WHO guidelines on indoor air quality should be implemented based on recent findings regarding the effects of prenatal exposure to indoor dampness on health effects of children further in life, including asthma, respiratory effects, eczema, and other immunological effects.

Effects of occupant behaviors on perceived dormitory air quality and sick building syndrome symptoms among female college students

We performed a cross-sectional survey of 2143 female students in a university in Tianjin, China regarding perceived air quality (PAQ) and sick building syndrome (SBS) symptoms in the student dormitory. The prevalence of general, mucosal, and skin symptoms was 22.1%, 21.9%, and 26.3%, respectively. The three most prevalent PAQ complaints were "dry air" (48.9% often), "stuffy odor" (18.2%), and "other unpleasant odors" (5.1%), and they were significant risk factors for 11-12 out of 12 SBS symptoms (adjusted odds ratios [AOR]: 1.6-5.8). Survey data of 1471 undergraduates, whose dorms were of uniform layout and furnishing, were used to further investigate the influences of occupancy level and occupant behaviors on PAQ and SBS symptoms. Frequent use of air freshener/perfume was a significant risk factor for "dry air," less frequent room cleaning and higher occupancy density were significant risk factors for "stuffy odor," and less natural ventilation was a significant risk factor for both "stuffy odor" and "pungent odor." These factors were also significantly associated with some SBS symptoms. In particular, the use of air freshener/perfume exhibited a significant dose-response pattern with "fatigue" (sometimes: AOR 1.3; often: AOR 2.0) and with "irritated, stuffy, or runny nose" (sometimes: AOR 1.6; often: AOR 2.2).

Analysis of the impact of a fresh air system on the indoor environment in office buildings

This study conducted objective physical tests and subjective questionnaire surveys related to the operation of a fresh air system in an office building in Beijing before the outbreak of the coronavirus disease 2019 (COVID-19). The long-term tests on indoor environmental parameters included air temperature, relative air humidity, air velocity, CO₂ concentration, PM_2.5 concentration, and fresh air volume, and the questionnaire surveyed the satisfaction of office workers in the indoor environment. The results showed that the indoor environmental parameters conformed to the values specified in relevant design standards; however, the satisfaction with the indoor environmental parameters was generally low. The probability of infection of indoor personnel with the virus causing COVID-19 under two existing fresh air system operation modes was calculated and compared, and it was less than 5%. A gray correlation analysis of the measured data with the questionnaire results identified indoor air temperature and quality as the main factors affecting the subjective satisfaction, which was consistent with the results of the questionnaire analysis. A new operation and maintenance method for fresh air systems was proposed for regular epidemic prevention and control to ensure the normal operation of the office building and the health of indoor personnel.

A Systematic Review of Associations between Energy Use, Fuel Poverty, Energy Efficiency Improvements and Health

Energy use in buildings can influence the indoor environment. Studies on green buildings, energy saving measures, energy use, fuel poverty, and ventilation have been reviewed, following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The database PubMed was searched for articles published up to 1 October 2020. In total, 68 relevant peer-reviewed epidemiological or exposure studies on radon, biological agents, and chemicals were included. The main aim was to assess current knowledge on how energy saving measures and energy use can influence health. The included studies concluded that buildings classified as green buildings can improve health. More efficient heating and increased thermal insulation can improve health in homes experiencing fuel poverty. However, energy-saving measures in airtight buildings and thermal insulation without installation of mechanical ventilation can impair health. Energy efficiency retrofits can increase indoor radon which can cause lung cancer. Installation of a mechanical ventilation systems can solve many of the negative effects linked to airtight buildings and energy efficiency retrofits. However, higher ventilation flow can increase the indoor exposure to outdoor air pollutants in areas with high levels of outdoor air pollution. Finally, future research needs concerning energy aspects of buildings and health were identified.

Prenatal and perinatal home environment and reported onset of wheeze, rhinitis and eczema symptoms in preschool children in Northern China

Early life environment can affect asthma and allergies but few cohort studies on this issue are available from China. Our aim was to investigate reported onset of childhood wheeze, rhinitis and eczema symptoms in relation to prenatal, perinatal and postnatal home environment. Data on home environment and symptoms (ISAAC based questions) in first two years of life and in the past 12 months were reported by parents of the children (3-6 y) in a cross-sectional questionnaire survey in ten day care centers in Taiyuan, northern China (N = 3606). Changes of symptoms from the first 2 years of life to the past 12 months (recall period) were calculated retrospectively. Multilevel logistic regression analysis was applied. Reported onset of wheeze, rhinitis and eczema were 11.8%, 22.2% and 3.3%, respectively. Redecorating during pregnancy increased reported onset of rhinitis (OR = 2.29) and eczema (OR = 4.91). New furniture during pregnancy increased reported onset of rhinitis (OR = 1.47). Perinatal indoor mould increased reported onset of wheeze (OR = 1.51), rhinitis (OR = 1.65) and eczema (OR = 1.91). Perinatal mould odour increased reported onset of wheeze (OR = 1.85). Perinatal window pane condensation increased reported onset of wheeze (OR = 1.54) and rhinitis (OR = 1.24). Perinatal stuffy air and dry air in the home increased reported onset of all three symptoms (ORs 1.46-2.24). Dog keeping increased reported onset of wheeze (OR = 1.69) and eczema (OR = 2.13). Based on principal component analysis, four exposure scores were calculated (renovation, new furniture, mould and indoor air quality scores). Dose-response relationships were observed between these exposure scores and reported onset of symptoms. In conclusion, prenatal and postnatal exposure to emissions from renovation and new furniture can increase reported onset of childhood wheeze, rhinitis and eczema. Perinatal indoor mould, mould odour, condensation on window panes and impaired indoor air quality at home can be associated with reported development of wheeze, rhinitis and eczema in preschoolers in northern China.

Relative humidity in droplet and airborne transmission of disease

A large number of infectious diseases are transmitted by respiratory droplets. How long these droplets persist in the air, how far they can travel, and how long the pathogens they might carry survive are all decisive factors for the spread of droplet-borne diseases. The subject is extremely multifaceted and its aspects range across different disciplines, yet most of them have only seldom been considered in the physics community. In this review, we discuss the physical principles that govern the fate of respiratory droplets and any viruses trapped inside them, with a focus on the role of relative humidity. Importantly, low relative humidity-as encountered, for instance, indoors during winter and inside aircraft-facilitates evaporation and keeps even initially large droplets suspended in air as aerosol for extended periods of time. What is more, relative humidity affects the stability of viruses in aerosol through several physical mechanisms such as efflorescence and inactivation at the air-water interface, whose role in virus inactivation nonetheless remains poorly understood. Elucidating the role of relative humidity in the droplet spread of disease would permit us to design preventive measures that could aid in reducing the chance of transmission, particularly in indoor environment.

Concentrations of Formic Acid, Acetic Acid, and Ammonia in Newly Constructed Houses

Herein, the concentrations of formic acid, acetic acid, and ammonia in samples of indoor air for 47 new houses were measured two weeks after completion. The houses were fabricated with light-gauge steel structures. The measurements were performed in living rooms and bedrooms without furniture and outdoors. Air samples were analyzed using ion chromatography. The mean values were 28 (living room), 30 (bedroom), and 20 μg m⁻³ (outdoor air) for formic acid; 166 (living room), 151 (bedroom), and 51 μg m⁻³ (outdoor air) for acetic acid; and 73 (living room), 76 (bedroom), and 21 μg m⁻³ (outdoor air) for ammonia. The total values of the three substances accounted for 39.4–40.7% of the sum of chemical compound values. The analyzed compounds were indicated by two principal components (PC), PC1 (30.1%) and PC2 (9%), with 39.1% total variance. Formic acid, acetic acid, and ammonia were positively aligned with PC1 and negatively aligned with PC2. Factors such as room temperature, aldehydes, and phthalates were positively aligned with PC1 and negatively aligned with PC2. Furthermore, concentrations of formic acid, acetic acid, and ammonia were significantly and positively correlated with room temperature (p < 0.05).

Effects of low-level inhalation exposure to carbon dioxide in indoor environments: A short review on human health and psychomotor performance

Scientific literature and documents pertaining to the effects of inhalation exposure to carbon dioxide (CO₂) on human health and psychomotor performance were reviewed. Linear physiological changes in circulatory, cardiovascular, and autonomic systems on exposure to CO₂ at concentrations ranging from 500 to 5000 ppm were evident. Human experimental studies have suggested that short-term CO₂ exposure beginning at 1000 ppm affects cognitive performances including decision making and problem resolution. Changes in autonomic systems due to low-level exposure to CO₂ may involve these effects. Further research on the long-term effects of low-level CO₂ exposure on the autonomic system is required. Numerous epidemiological studies indicate an association between low-level exposure to CO₂ beginning at 700 ppm and building-related symptoms. Respiratory symptoms have been indicated in children exposed to indoor CO₂ concentrations higher than 1000 ppm. However, other indoor comorbid pollutants are possibly involved in such effects. In the context of significant linear increase of globally ambient CO₂ concentration caused by anthropogenic activities and sources, reducing indoor CO₂ levels by ventilation with ambient air represents an increase in energy consumption in an air-conditioned building. For the efficient energy control of CO₂ intruding a building from ambient air, the rise of atmospheric CO₂ concentration needs to be urgently suppressed.

How home ventilation rates affect health: A literature review

This paper reviews studies of the relationships between ventilation rates (VRs) in homes and occupant health, primarily respiratory health. Five cross-sectional studies, seven case-control studies, and eight intervention studies met inclusion criteria. Nearly all studies controlled for a range of potential confounders and most intervention studies included placebo conditions. Just over half of studies reported one or more statistically significant (SS) health benefits of increased VRs. Wheeze was most clearly associated with VR. No health outcomes had SS associations with VRs in the majority of statistical tests. Most studies that reported SS health benefits from increased VRs also had additional health outcomes that did not improve with increased VRs. Overall, the number of SS improvements in health with increased VRs exceeded the anticipated chance improvements by approximately a factor of seven. The magnitude of the improvements in health outcomes with increased VRs ranged from 20% to several-fold improvements. In summary, the available research indicates a tendency for improvements in respiratory health with increased home VRs; however, health benefits do not occur consistently and other exposure control measures should be used together with ventilation. The research did not enable identification of a threshold VR below which adverse health effects occur.

Climate impact on spreading of airborne infectious diseases: Complex network based modeling of climate influences on influenza like illnesses

In this study we combined a wide range of data sets to simulate the outbreak of an airborne infectious disease that is directly transmitted from human to human. The basis is a complex network whose structures are inspired by global air traffic data (from openflights.org) containing information about airports, airport locations, direct flight connections and airplane types. Disease spreading inside every node is realized with a Susceptible-Exposed-Infected-Recovered (SEIR) compartmental model. Disease transmission rates in our model are depending on the climate environment and therefore vary in time and from node to node. To implement the correlation between water vapor pressure and influenza transmission rate [J. Shaman, M. Kohn, Proc. Natl. Acad. Sci. 106, 3243 (2009)], we use global available climate reanalysis data (WATCH-Forcing-Data-ERA-Interim, WFDEI). During our sensitivity analysis we found that disease spreading dynamics are strongly depending on network properties, the climatic environment of the epidemic outbreak location, and the season during the year in which the outbreak is happening.

Simulation of vertical concentration gradient of influenza viruses in dust resuspended by walking

Particles are resuspended from the floor by walking and are subject to turbulent transport in the human aerodynamic wake. These processes may generate a vertical concentration gradient of particles. To estimate the magnitude of turbulence generated by walking, we measured the velocity field in the wake from floor to ceiling at 10-cm intervals with a sonic anemometer. The resulting eddy diffusion coefficients varied between 0.06 and 0.20 m(2) /s and were maximal at ~0.75-1 m above the floor, approximately the height of the swinging hand. We applied the eddy diffusion coefficients in an atmospheric transport model to predict concentrations of resuspended influenza virus as a function of the carrier particle size, height in the room, and relative humidity, which affects the resuspension rate coefficient and virus viability. Results indicated that the concentration of resuspended viruses at 1 m above the floor was up to 40% higher than at 2 m, depending on particle size. For exposure to total resuspended viruses, the difference at 1 vs. 2 m was 11-14%. It is possible that shorter people are exposed to higher concentrations of resuspended dust, including pathogens, although experimental evidence is needed to verify this proposition.

PRACTICAL IMPLICATIONS

Forces generated by walking can resuspend particles from the floor and create higher concentrations close to the floor and lower concentrations above it. These particles may include pathogens, such as the influenza virus, that were previously emitted into the air by an infected individual and that settled to the ground. Due to particle resuspension and turbulent transport, it is possible that shorter people are exposed to higher concentrations of particles, including certain pathogens, than are taller people. This work could be used in support of epidemiological investigations into the incidence of influenza as a function of a person’s height and to guide the design of more effective control strategies to reduce transmission of influenza.

Effect of Traffic Exposure on Sick Building Syndrome Symptoms among Parents/Grandparents of Preschool Children in Beijing, China

INTRODUCTION

Sick building syndrome (SBS) includes general, mucosal and skin symptoms. It is typically associated with an individual's place of work or residence. The aim of this study was to explore the effect of traffic exposure on SBS symptoms in Beijing, China.

METHODS

From January to May, 2011, recruitment occurred at kindergartens in 11 districts in Beijing. Self-administered questionnaires were distributed by teachers to legal guardians of children and then returned to teachers. The questionnaire asked them to recall the presence of 12 SBS symptoms from the previous three months. Living near a highway or main road (within 200 meters) was used as a proxy for traffic exposure. Multivariable logistic regression was used to test the association between traffic exposure and a higher number of SBS symptoms, controlling for key covariates.

RESULTS

There were 5487 valid questionnaires (65.0% response rate). Univariate analysis showed that living near a main road or highway (OR = 1.40), female gender (OR = 1.44), and environmental tobacco smoking (ETS) (OR = 1.13) were significant risk factors for general symptoms. Grandparent's generation (OR = 0.32) and home ownership (owner vs. renter) (OR = 0.89) were significant protective factors. The adjusted odds ratio (aOR) for the association between living close to a highway and general symptoms remained significant in the multivariable model (aOR = 1.39; 95% CI = 1.21: 1.59). ORs and aORs were similar for mucosal and skin symptoms.

CONCLUSIONS

This study found traffic exposure to be significantly associated with SBS symptoms. This finding is consistent with current literature that indicates an association between adverse health effects and living near highway or main road.

Odors and sensations of humidity and dryness in relation to sick building syndrome and home environment in Chongqing, China

The prevalence of perceptions of odors and sensations of air humidity and sick building syndrome symptoms in domestic environments were studied using responses to a questionnaire on the home environment. Parents of 4530 1–8 year old children from randomly selected kindergartens in Chongqing, China participated. Stuffy odor, unpleasant odor, pungent odor, mold odor, tobacco smoke odor, humid air and dry air in the last three month (weekly or sometimes) was reported by 31.4%, 26.5%, 16.1%, 10.6%, 33.0%, 32.1% and 37.2% of the parents, respectively. The prevalence of parents’ SBS symptoms (weekly or sometimes) were: 78.7% for general symptoms, 74.3% for mucosal symptoms and 47.5% for skin symptoms. Multi-nominal regression analyses for associations between odors/sensations of air humidity and SBS symptoms showed that the odds ratio for “weekly” SBS symptoms were consistently higher than for “sometimes” SBS symptoms. Living near a main road or highway, redecoration, and new furniture were risk factors for perceptions of odors and sensations of humid air and dry air. Dampness related problems (mold spots, damp stains, water damage and condensation) were all risk factors for perceptions of odors and sensations of humid air and dry air, as was the presence of cockroaches, rats, and mosquitoes/flies, use of mosquito-repellent incense and incense. Protective factors included cleaning the child’s bedroom every day and frequently exposing bedding to sunshine. In conclusion, adults’ perceptions of odors and sensations of humid air and dry air are related to factors of the home environment and SBS symptoms are related to odor perceptions.

Relationship between humidity and influenza A viability in droplets and implications for influenza's seasonality

Humidity has been associated with influenza’s seasonality, but the mechanisms underlying the relationship remain unclear. There is no consistent explanation for influenza’s transmission patterns that applies to both temperate and tropical regions. This study aimed to determine the relationship between ambient humidity and viability of the influenza A virus (IAV) during transmission between hosts and to explain the mechanisms underlying it. We measured the viability of IAV in droplets consisting of various model media, chosen to isolate effects of salts and proteins found in respiratory fluid, and in human mucus, at relative humidities (RH) ranging from 17% to 100%. In all media and mucus, viability was highest when RH was either close to 100% or below ∼50%. When RH decreased from 84% to 50%, the relationship between viability and RH depended on droplet composition: viability decreased in saline solutions, did not change significantly in solutions supplemented with proteins, and increased dramatically in mucus. Additionally, viral decay increased linearly with salt concentration in saline solutions but not when they were supplemented with proteins. There appear to be three regimes of IAV viability in droplets, defined by humidity: physiological conditions (∼100% RH) with high viability, concentrated conditions (50% to near 100% RH) with lower viability depending on the composition of media, and dry conditions (<50% RH) with high viability. This paradigm could help resolve conflicting findings in the literature on the relationship between IAV viability in aerosols and humidity, and results in human mucus could help explain influenza’s seasonality in different regions.

School environment as predictor of teacher sick leave: data-linked prospective cohort study

Background

Poor indoor air quality (IAQ) and psychosocial problems are common in schools worldwide, yet longitudinal research on the issue is scarce. We examined whether the level of or a change in pupil-reported school environment (IAQ, school satisfaction, and bullying) predicts recorded sick leaves among teachers.

Methods

Changes in the school environment were assessed using pupil surveys at two time points (2001/02 and 2004/05) in 92 secondary schools in Finland. Variables indicating change were based on median values at baseline. We linked these data to individual-level records of teachers’ (n = 1678) sick leaves in 2001–02 and in 2004–05.

Results

Multilevel multinomial logistic regression models adjusted for baseline sick leave and covariates showed a decreased risk for short-term (one to three days) sick leaves among teachers working in schools with good perceived IAQ at both times (OR = 0.6, 95% CI: 0.5-0.9), and for those with a positive change in IAQ (OR = 0.6, 95% CI: 0.4-0.9), compared to teachers in schools where IAQ was constantly poor. Negative changes in pupil school satisfaction (OR = 1.8, 95% CI: 1.1-2.8) and bullying (OR = 1.5, 95% CI: 1.0-2.3) increased the risk for short-term leaves among teachers when compared to teachers in schools where the level of satisfaction and bullying had remained stable. School environment factors were not associated with long-term sick leaves.

Conclusions

Good and improved IAQ are associated with decreased teacher absenteeism. While pupil-related psychosocial factors also contribute to sick leaves, no effect modification or mediation of psychosocial factors on the association between IAQ and sick leave was observed.

Carbon dioxide (CO2) demand-controlled ventilation in university computer classrooms and possible effects on headache, fatigue and perceived indoor environment: an intervention study

PURPOSE

To study the effects of a CO(2) demand-controlled ventilation system (variable flow) in computer classrooms on perceived air quality and sick building syndrome.

METHODS

University students (27% women) participated in a blinded study. Two classrooms had variable flow (mean 5.56 ac/h); two others had constant ventilation flow (mean 5.07 ac/h). After one week, ventilation conditions were shifted. The students reported symptoms/perceptions during the last hour on rating scales. Temperature, air humidity, CO(2), PM10 and number concentration of particles were measured simultaneously. Cat (Fel d 1), dog (Can f 1), horse (Equ cx) and house dust mites (Der f 1 and Der p 1) allergens were measured in dust. Those participating twice in the same classroom (N = 61) were analysed longitudinally.

RESULTS

Mean CO(2) was 784 ppm (9% of time >1,000 ppm) with variable flow and 809 ppm with constant flow conditions (25% of time >1,000 ppm). Mean temperature (22.6 °C), PM10 (18 μg/m(3)) and number concentration (1,860 pt/cm(3)) were unchanged. The median levels of cat, dog, horse and Der f 1 allergens were 10,400 ng/g, 4,900 ng/g, 13,700 U/ng and 260 ng/g dust, respectively. There were slightly less headache (p = 0.003), tiredness (p = 0.007) and improved perceived air quality (p = 0.02) with variable flow.

CONCLUSIONS

Use of a CO(2)-controlled ventilation system, reducing elevated levels of CO(2), may slightly reduce headache and tiredness and improve perceived air quality. The high levels of pet allergens, due to track in of allergens from the home and possible accumulation due to electrostatic forces, illustrate a need for improved cleaning.

Absolute humidity modulates influenza survival, transmission, and seasonality

Influenza A incidence peaks during winter in temperate regions. The basis for this pronounced seasonality is not understood, nor is it well documented how influenza A transmission principally occurs. Previous studies indicate that relative humidity (RH) affects both influenza virus transmission (IVT) and influenza virus survival (IVS). Here, we reanalyze these data to explore the effects of absolute humidity on IVT and IVS. We find that absolute humidity (AH) constrains both transmission efficiency and IVS much more significantly than RH. In the studies presented, 50% of IVT variability and 90% of IVS variability are explained by AH, whereas, respectively, only 12% and 36% are explained by RH. In temperate regions, both outdoor and indoor AH possess a strong seasonal cycle that minimizes in winter. This seasonal cycle is consistent with a wintertime increase in IVS and IVT and may explain the seasonality of influenza. Thus, differences in AH provide a single, coherent, more physically sound explanation for the observed variability of IVS, IVT and influenza seasonality in temperate regions. This hypothesis can be further tested through future, additional laboratory, epidemiological and modeling studies.